Prevalência de anticorpos antitireoidianos e de disfunção da tireoide em pacientes com Lúpus Eritematoso Sistêmico

Abstract

The objective of the present study was to assess the prevalence of autoimmune thyroid disease (ATD) and thyroid dysfunction (TD) in patients with systemic lupus erythematosus (SLE). Seventy-nine SLE patients (American College of Rheumatology criteria) and 159 control patients with no diagnosis of autoimmune diseases (except for ATD) were consecutively evaluated with respect to changes in laboratory results of thyroid function and the presence of ATD. ATD was detected in 11.4 % of the SLE patients and in 13.8 % of the control patients (p= 0.747), whereas TD was detected in 25.3 % and 9.4 % (p= 0.002), hypothyroidism was detected in 21.5 % and 6.9 % (p= 0.002), and hyperthyroidism was detected in 3.8 % and 2.5 % (p= 0.426) of the SLE and control patients, respectively. No relation was observed between SLE disease activity and ATD or TD. The mean duration of SLE was higher in patients with TD (p= 0.036). Mild hypothyroidism was more frequent in the SLE patients with anti-Smith (anti-SM) antibodies (p= 0.029), and TD was more common in patients with discoid lupus (p= 0.020). In contrast, moderate/severe hypothyroidism was less frequent in SLE patients with malar rash (p= 0.038) and more frequent in those with lupus nephritis (p= 0.041). Because hypothyroidism was more frequent in the SLE patients and given the high frequency of ATD in both groups, the authors suggest that TSH and anti-thyroid antibody levels be assessed in SLE patients.